Clinical Analysis In Patients With Cerebral Aneurysms Of Posterior Circulation

A series of 101 consecutive patients with cerebral aneurysms of the vertebrobasilar system is presented. Mean age was 52.8 years. The overall mortality and morbidity rates were 17.8% and 13.9%, respectively. The most common cause of death was rebleeding (61.1%, 11/18). Treatments consisted of neck clipping in 23 patients, wrapping in 5, and endovascular therapy in 33. Patients with Hunt and Hess Grades I and II had good outcome in 85.7% (42/49). Patients with aneurysms which were located proximally had better outcome than those with distal aneurysm. Twenty-nine (87.9%) out of thirty-three patients who were treated with endovascular therapy showed favorable outcome, whereas only 60.7% (17/28) of patients who underwent craniotomy showed favorable one, which showed statistical significance (p=0.032). These results indicated that clinical grade of patients was a critical factor for the outcome. Endovascular coiling was significantly better than open surgery in terms of outcome, especially for the distal aneurysms including basilar tip.